Lexington Medical Center has become the first hospital in South Carolina to implant a new wireless pacemaker known as Micra™ into a patient to fix a slow heartbeat. Called the world’s smallest pacemaker, this device is not visible under the skin, and because there are no wires connected to it, there is a lower risk of complications. The Lexington Medical Heart Center team performed this pacemaker implantation inside the hospital’s cardiac electrophysiology lab on March 14, 2017.

“This device represents a significant breakthrough in pacing technology,” said William W. Brabham, MD, FHRS, of Lexington Cardiology, a Lexington Medical Center physician practice. “The ability to deliver pacing therapy using such a small device is revolutionary. It’s very exciting to think of the possibilities in the future.”

Dr. William Brabham

A pacemaker helps restore a healthy heart rhythm by sending tiny electrical signals to the heart to increase the heart rate. Traditionally, pacemakers have been implanted below the collarbone through an incision and have included leads, which are insulated wires. The leads carry the electrical impulse from the pacemaker to the heart.

The size of a vitamin capsule, Micra is more than 90 percent smaller than other pacemakers. It’s implanted in a minimally-invasive procedure through a vein in the leg directly into the heart, removing the need for leads to act as pulse generators and the appearance of any visible scar below the collarbone. Because leads in traditional pacemakers may shift, there is a small risk of those devices not working properly when needed; with no leads, Micra eliminates that concern. Also, its size and location can mean fewer post-implant activity restrictions and no obstructions to shoulder movement.

Micra

Manufactured by Medtronic, Micra is the first FDA-approved wireless pacemaker. It’s for patients who need a single chamber pacemaker. The device has more than a 99 percent implant success rate and 48 percent fewer major complications reported than with traditional pacemakers.

The Lexington Medical Heart Center team has received extensive training on proper device implantation. Dr. Brabham and Robert Malanuk, MD, FACC, performed the first Micra implantation at the hospital

Janet Smoak knew something was wrong. She was gaining weight, felt depressed, confused, out of breath, dizzy and exhausted.

“There was a time that I stayed in bed for three days” she said. “I couldn’t walk from one side of my office to the other without being out of breath.”

Janet Smoak inside Lexington Medical Center

Janet is a 46-year-old wife and mother of two sons who works as a division administrator for Lexington Medical Center’s Physician Network. She went to her doctor, thinking she was falling apart.

She underwent every screening from blood work to heart tests at Lexington Cardiology, a Lexington Medical Center physician practice. Ultimately, doctors determined Janet had a condition called bradycardia, which is an abnormally slow heart rate.

The doctors wanted to implant a pacemaker. With her symptoms continuing to get worse, she agreed.

William Brabham, MD, FHRS, an electrophysiologist at Lexington Cardiology, was Janet’s doctor.

Dr. William Brabham

“It’s reasonable to implant a pacemaker if patients have a low resting heart rate and fatigue, shortness of breath with activity, and the inability to increase their heart rate appropriately,” Dr. Brabham said. “It’s also recommended if people have passed out and have low resting heart rates.”

Dr. Brabham and his team inserted the pacemaker below the collar bone and passed wires into the heart to help promote a healthy heart rate. The results were excellent.

“After I got the pacemaker, I immediately started feeling better and had energy,” Janet said. “I can honestly say for the first time, ‘I feel good.’”

An abnormally slow heart rate is usually defined as less than 60 beats per minute. But a slow heart rate on its own does not necessarily indicate a problem. For example, some well-conditioned athletes have slow resting heart rates. And fatigue may not indicate a heart problem; instead, it could simply be a result of the hectic pace of life. But when several symptoms are present, it’s time to take a closer look.

Since having the pacemaker implanted nearly one year ago, Janet has lost 30 pounds, has more energy and feels good again.

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